Girl Doc Survival Guide
Young doctors are increasingly in ‘survival’ mode.
Far from flourishing, the relentless pressure of working in medicine means that ‘balance’ is harder than ever to achieve.
On the Girl Doc Survival Guide, Yale professor and dermatologist Dr Christine J Ko sits down with doctors, psychologists and mental health experts to dig into the real challenges and rewards of life in medicine.
From dealing with daily stressors and burnout to designing a career that doesn’t sacrifice your personal life, this podcast is all about giving you the tools to not just survive...
But to be present in the journey.
Girl Doc Survival Guide
EP128: Understanding Behavior Through Physiology: Dr. Benno Torgler's Approach
In this episode of SEE HEAR FEEL, host Christine welcomes Dr. Benno Torgler, a Professor of Economics at Queensland University of Technology. They discuss Dr. Torgler's fascinating journey from mechanical engineering to economics and his significant research on heart rate variability (HRV). The conversation delves deep into the integration of physiological measurements with psychological and emotional activities, providing insights on how HRV can be used to understand human behavior and stress. Dr. Torgler also shares personal anecdotes and offers practical advice for using wearable technology to monitor HRV.
00:00 Introduction to Dr. Benno Torgler
01:09 A Personal Journey: From Engineering to Economics
03:54 Understanding Heart Rate Variability
08:21 Applications and Implications of Heart Rate Variability
12:01 Final Thoughts and Reflections
Dr. Benno Torgler, PhD is a Professor of Economics in the School of Economics and Finance as well as Director of the Australian Research Council Training Centre for Behavioural Insights for Technology Adoption (BITA) in the Queensland University of Technology in Queensland, Australia. He is a social scientist that studies human decision making and human nature via integrating economics, social and evolutionary psychology, sociology, and biology. He has co-written an article titled, “Positive affect and heart rate variability: a dynamic analysis” which looks at physiologic measurements (for example, heart rate variability) and self-reported measures to better understand human behavior and interactions. His research is helpful in understanding how to collect such physiologic data like heart rate variability as well as how to model and interpret it.
Christine Ko: [00:00:00] Welcome back to SEE HEAR FEEL. Today, I am happy to be with Dr. Benno Torgler. Dr. Torgler, PhD, is a Professor of Economics in the School of Economics and Finance, as well as Director of the Australian Research Council Training Centre for Behavioural Insights for Technology Adoptation in the Queensland University of Technology in Queensland, Australia. He is a social scientist. That studies human decision making and human nature via integrating economics, social and evolutionary psychology, sociology, and biology. He has co written an article titled, "Positive Affect and Heart Rate Variability, a Dynamic Analysis" which looks at physiologic measurements like heart rate variability and self reported measures to better understand human behavior and interactions. His research is helpful in understanding how to collect such physiologic data like heart rate variability [00:01:00] as well as how to model and interpret it.
Thank you to Dr. Torgler for doing this with me.
Benno Torgler: Thank you very much for having me, Christine. It's wonderful to be here.
Christine Ko: Thank you. Could you first share a personal anecdote about yourself?
Benno Torgler: Sure. After I finished high school, where I had focused on math and natural sciences, I decided to study mechanical engineering at the ETH Zurich, that's a renowned federal institute of technology. My father, who was an engineer himself, passed away just a few weeks before I finished high school. So I felt a strong urge to make him proud and follow his footsteps. However, during my first lecture on mechanics, the professor mentioned that the only Bible we need to study was his manuscript. I felt really shocked about it. And I was thinking, how can someone who is so smart be so narrow minded.
And I started to think, am I going to end up the same way? If I study that kind of area? And I also quickly realized that I was more [00:02:00] interested in understanding why engineers were so interested in creating technology rather than technology itself. Luckily, I failed the major examination of the year, which made my decision to quit much easier. After I quit, my brother suggested that I would make a good economist. He gave me a first year economics textbook by Rene Frey, and I read it eagerly within a few days, and five years later, Rene Frey became my principal supervisor when I started my PhD at the University of Basel. It just happened. My first economics lecture, the professor emphasized that you can't just rely on one source of information. So I immediately felt at home in that environment. I don't know whether you know the old joke that if you put 10 economists in a room, you will get 11 opinions. So I enjoy being in this kind of room. Quitting engineering was probably one of my best [00:03:00] decisions I ever made. You have behavioral economists in your podcast, so we often have this kind of bias against change, or we hear about, winners never quit, and perseverance, which is very important, or grit is seen often as a virtue, which then actually leads to the situation that sometimes we don't leave soon enough or at all. Sometimes it's a good idea to quit and in my case, I think it was a good one.
Christine Ko: I thank you for sharing all that. It sounds like it was a difficult time with your father passing.
Benno Torgler: It took me a year to recover.
Christine Ko: You were close.
Benno Torgler: Yeah, definitely.
Christine Ko: But I really appreciate your story and how you really talked about failure and the concept of quitting and how we are resistant to change. Sometimes failure really leads to something that's much better.
Benno Torgler: Yeah.
Christine Ko: I got introduced to your work recently because I have a Oura ring, and [00:04:00] I had learned about heart rate variability potentially being a good measure of parasympathetic tone or vagal tone, the opposite of sympathetic -that fight or flight response.
Can you talk a little bit about heart rate variability and your article and your thoughts?
Benno Torgler: Yeah, sure. Originally, obviously, heart rate variability was used to identify medical conditions. In recent years, scholars have also linked heart rate variability with psychological, mental and emotional activities, which is really exciting from a social science perspective. Emotions are not only cognitive, but also physical as the great William James emphasized. For example, there's some really cool studies on the level of cortisol affects your memory and brain regions can increase the amygdala, that makes you more emotional. Or, for example, continuous increase of cortisol can affect anxiety. [00:05:00] The production of testosterone effects, for example, confidence and risk behavior. And that's wonderful work by Robert Sapolsky, you know, the book Behave: you know, The Biology of Human at our Best and Worst. It's a wonderful testament about exploring, you know, body and brain. Body and the mind.
As you already emphasized, the heart rate variability provides information on the activity of two major parts of the autonomic nervous system, the sympathetic and parasympathetic. Yes, the sympathetic one is this fight and flight response, which affects the heart rate indirectly. The sympathetic nerves release stimulating hormones, adrenaline kick into the bloodstream. While the parasympathetic emphasizes importance of this rest and relaxation directly through vagal nerves connection to specific pacemaker cells.
You can create proxies, for example, to measure levels of stress, [00:06:00] and then link it to conditions that you're experiencing in your daily activities. And some even call it the cardiac signature of emotionality. So it's a nice proxy to work with as a social scientist in that sense. It's non intrusive. It gives us almost like a digital footprint or breadcrumb.
We had a relatively nice sample size of 300 individuals with in total 5, 000 core activities, and then we were able then to explore the correlation between the physiological measurement, the heart rate variability, with actually a subjective assessment of individuals positive affects and see whether it's correlated. We have a lot of people worked in that project. Tony Beatton helped the paper a lot. Ho Fai Chan, who is our empirical wizard, did some really good work. Uwe Dulleck, who is a behavioral economist. Andrea Ristl collected the data in Europe. Markus Schaffner, who was [00:07:00] a former PhD student of mine and a postdoc who worked intensively on heart rate variability in his work and was an excellent programmer too, which is really important with this, when you work with dynamic data. This kind of project took many years to get it finally published in that sense.
Christine Ko: Yeah. What do you think about this type of wearable ring, like the Oura ring or the Whoop bracelet? They measure heart rate variability.
Benno Torgler: Yeah, different kind of gadgets provide different information. So if you look at, you see, see, for example, where is your baseline? And how to deviate from the baseline. I think that's really useful. And I think we have not yet paid a lot of attention like in economics and behavioral economics around activities. A lot is going on throughout the day. So it's good to look at dynamics. Once you look at dynamics, you can go much deeper into things like imagination and anticipation. For example, I know that in half an hour, I'm [00:08:00] going to play soccer, and I'm already excited now, and you would see that also in your physiological response. The Homo economicus, or the psychology version, is usually through looking at the present and the past. But I think many things that we are doing is also driven by what we expect will happen. I'm going on holidays in a week. I'm excited about it. And our brain is also a predictive machine in a sense that survival advantage is through predicting what's happening. So it's really important to have ways of measuring things like anticipation. And I think those physiological tools also helps you to do that.
Christine Ko: That's cool. So your study, how do you think it applies to someone like me who has a ring that's measuring heart rate variability? Is there some way that I can use what your study found?
Benno Torgler: We found there is a negative correlation between mental stress and physiological state. Your subjective feeling of [00:09:00] it is also a good guidance. So you can rely also on, if you ask yourself, how am I feeling at the moment? Our results would indicate that is quite reliable in a short period of time. I think it also is interesting from a perspective of there are activities really good for us. So physical activity, relaxation, early mornings works well for us. The length also matters. If you exercise too long, that can lead to stress.
There are things that, for example, are more challenging. For example, communication. That can actually lead to stress. So it's good to have social interactions, but also communication can be draining. So it's good to be aware of those kind of factors in your daily activities and then be conscious about it. Maybe find heuristics, how to cope with it. Maybe think about stress resistance a bit better. I feel like we need more research on what makes us more stress resilient. For example, if there are a lot of unpredictable elements in our life, [00:10:00] that actually increases stress levels.
Christine Ko: So ultimately, though you think that heart rate variability for a given individual is a very useful data point?
Benno Torgler: I think so. I think when you always don't understand human nature, you need different kinds of tools. Heart rate variability is not as precise, for example, as brain scanning where you see exactly what lights up. And it's sometimes messy in the sense, for example, is it now stress or is it excitement? So it's not always easy. You need to be fully aware of shortcomings of technology that you're using. But I think all these different kind of sensory technologies allow us now to really start better understanding how people are interacting with each other, in the real world, not just, for example, in the lab, or in fMRI, which is very artificial. You can start understanding how they interact outside which is where we are active. And then you can extend things [00:11:00] by really exploring group behaviors, all human activities that we are doing, and then see what's happening there. And that's actually quite exciting.
Christine Ko: Have you ever used heart rate variability on yourself?
Benno Torgler: I did. Yes, and I identified where do I need to be careful? What is an indication where I am? Situations where I'm more bored or not. But this is all something that you need to be careful with. If you constantly follow measurements, that can also be stressful. So don't overly rely on constantly observing you in that sense, because that itself can be extremely stressful. So find the right balance. Test things out. For example, let's say I'm going to have a lecture, and I want to see now how, what's happening with my heart rate before, during and after the lecture to see where I am. And then I don't have to do it each time I do the lecture in that sense.
To understand better what's going on with an individual, also understand you in different [00:12:00] situations. We always play different roles in our real world. In your case you're a professor, you have a medical degree. But you also are a mom and an author and you have a podcast and you always have different roles to play in those different environments. Understanding how does different roles play with your physiology, with your body, and your emotionality is actually quite interesting.
Christine Ko: Do you have any final thoughts?
Benno Torgler: What's your thoughts about it? How is it helping you?
Christine Ko: I agree with what you said that sometimes the data can be stressful. There's another measurement on this Oura ring called heart health or something like that. It tells me that I'm like X number of years above or below my actual age. And so my heart health is good. It's below my actual age. But recently in the last couple of weeks, I have lost three years of heart health. But I can see [00:13:00] how that would be very stressful to someone, like, I've lost three years of life. The debt data is not accurate. Who's to really say that I'm really going to live three years less now. In that sense, it's not real data. But the data was accurate in the sense that I wasn't feeling well, and I was very tired.
Benno Torgler: Very important point is the change is interesting. So the change can help you identify, okay, that's something I need to pay attention to. But yeah, it's based on estimates. It's based on algorithm. It's based on averages. So yeah, be really careful.
I, for example, had really bad sleep scores for a while, and I was really worried. I thought, I'm a really good sleeper. And then I just changed in the settings what's my average sleep, and then suddenly have really good scores. Go back to your settings and also look at those settings carefully before you make judgments.
Nothing is perfect, and I think it's good to [00:14:00] be aware of what you're actually using and what the data tells you and what you shouldn't really believe.
Christine Ko: Yeah. Thank you so much for spending this time with me.
Benno Torgler: Thanks for having me. It was a wonderful chat with you, Christine, and I wish you all the best.